Knowledge, attitudes and practices of general practitioners and paediatricians towards Group A beta-haemolytic streptococcal tonsillopharyngitis: A cross-sectional study from Türkiye

Abstract

Background and objectiveGeneral practitioners (GPs) and paediatricians are very important in the management of sore throat in terms of providing correct diagnosis and treatment. The aim of this study was to evaluate the knowledge, attitudes and practices of GPs and paediatricians towards Group A beta-haemolytic streptococcal (GABHS) tonsillopharyngitis. MethodsThree vignettes/case studies, in which the causative agents were GABHS, Epstein-Barr virus (EBV) and non-EBV viral infection, were presented as part of a questionnaire sent to paediatricians and GPs to elicit information regarding their diagnosis and treatment of tonsillopharyngitis. ResultsIn all, 236 physicians responded to the questionnaire (126 paediatricians, 106 GPs). GPs registered more accurate diagnoses of GABHS tonsillopharyngitis and tended to administer more symptomatic treatment in the case of non-EBV tonsillopharyngitis than paediatricians. Paediatricians requested more tests in the diagnosis of GABHS tonsillopharyngitis than GPs. DiscussionMost GPs and paediatricians possess adequate knowledge regarding GABHS diagnosis and the differential diagnosis of patients. Differences between the hospital and general practice settings may have affected the approach to symptomatic treatment and requesting tests.SORE THROAT is one of the most common and frequently seen complaints in children. 1 Because viral infections are responsible for most cases of acute pharyngitis in children, most paediatric patients with a sore throat do not require antibiotic therapy. 2 However, antibiotics are frequently and inappropriately prescribed for children with a sore throat, even in high-income countries. 3,4 This results in considerable spending on unnecessary healthcare and in antimicrobial resistance in the community. 5,6 The most frequent bacterial cause for which antibiotic therapy is definitely required in the case of acute pharyngitis is Group A beta-haemolytic streptococcus (GABHS), seen in 30% of cases of sore throat in the paediatric population. 7 Streptococcal infections can lead to life-threatening non-suppurative complications (eg acute rheumatic fever, glomerulonephritis and paediatric autoimmune neuropsychiatric disorders) and suppurative complications (peritonsillar abscess, septic jugular vein thrombophlebitis, Vincent's angina) requiring emergency medical or surgical intervention. 8 Complications such as acute rheumatic fever, which are responsible for significant mortality and morbidity, are 100-200% more prevalent in low-and middleincome countries than in high-income countries. 9 However, because the signs and symptoms of GABHS pharyngitis cannot generally be differentiated from other causes of sore throat, diagnosis is difficult. 10 GABHS pharyngitis has potentially life-threatening complications, whereas viral pharyngitis does not even require antibiotics; so, the decision process is important for clinicians. Diagnostic and therapeutic guidelines are available to standardise clinician approaches. 7,[11][12][13] COVID-19 spread across the globe at ...